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JP2000516504A - Monitoring system for regular intake of drugs - Google Patents

Monitoring system for regular intake of drugs

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JP2000516504A
JP2000516504A JP10510244A JP51024498A JP2000516504A JP 2000516504 A JP2000516504 A JP 2000516504A JP 10510244 A JP10510244 A JP 10510244A JP 51024498 A JP51024498 A JP 51024498A JP 2000516504 A JP2000516504 A JP 2000516504A
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detection
monitoring system
dosage form
labeling substance
drug
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バッツ,ハンス―ゲオルグ
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ロシュ ダイアグノスティックス ゲーエムベーハー
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6802Sensor mounted on worn items
    • A61B5/681Wristwatch-type devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/14532Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration or pH-value ; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid or cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
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    • G01MEASURING; TESTING
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    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/58Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving labelled substances
    • G01N33/582Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving labelled substances with fluorescent label
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

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  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Urology & Nephrology (AREA)
  • Optics & Photonics (AREA)
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  • Biochemistry (AREA)
  • General Physics & Mathematics (AREA)
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  • Biotechnology (AREA)
  • Emergency Medicine (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

(57)【要約】 患者による薬剤の規則的摂取を監視するための制御システム。該システムは、相互に適合させた、薬物療法のための薬剤投与剤形(1)と該薬剤投与剤形に含まれる検出物質(3)の患者の体内での非侵入性検出のための検出装置(2)とを含むシステム構成要素を含んでなる。該検出装置(2)は、患者の体内における検出物質の存在に相関する物理的に測定可能なパラメーターの、試薬を用いない直接的測定に適している。 (57) [Summary] A control system for monitoring the regular intake of drugs by patients. The system is adapted for non-invasive detection in a patient of a drug dosage form (1) for drug therapy and a detection substance (3) contained in the drug dosage form, which are mutually compatible. And system components including the device (2). The detection device (2) is suitable for direct measurement without a reagent of a physically measurable parameter correlated with the presence of a detection substance in a patient's body.

Description

【発明の詳細な説明】 薬剤の規則的摂取の監視システム 本発明は、患者による薬剤の規則的摂取の監視システム、ならびにかかる監視 システム用の薬剤投与剤形に関する。 薬剤の規則的摂取は、その有効性のために極めて重要であることが多い。例え ば、抗生物質を用いる場合、不完全な終了は疾病の再発や耐性の形成をもたらす 。しかし、薬剤は処方に従い規則的に服用されないことや、不完全な段階で摂取 が中断されることがしばしばある。従って、薬剤の規則的摂取が極めて重要であ る特定の治療については(例えば、TBC、HIVおよび他の重篤な感染症)、薬剤の 規則的投与の個々の監視を保証するためには、患者の入院治療が必要とされる。 このような、ただ薬剤の摂取を監視するという理由のためだけの患者の入院治療 は、回復過程に不利となる可能性があり、また非常に高額の費用がかかる。 従って、妥当な費用で薬剤の規則的摂取の信頼性のある監視が差し迫って必要 である。今のところ、この問題に対する解決策はない。薬物療法を含むいくつか の治療については、血中の薬剤濃度の分析検査(いわゆる「薬物試験」)を行っ て薬剤の至適有効濃度を調整する。しかしながら、このような分析法は、少数の 薬剤でしか利用できず、それぞれの検査について血液を採取し、同時に比較的難 しい分析法を行う必要がある。薬物試験では、患者による薬剤摂取の自己監視は できないし、医師は患者の協力なしでは薬剤の規則的な摂取を監視することがで きない。 この問題を解決するため、本発明は、相互に適合させたシステム構成要素とし て、薬剤の投与剤形および患者の体内におけるその投与剤形に含まれる物質(以 下「検出物質」という)の非侵入性検出のための検出装置を含む監視システムを 提案するものである。該検出装置は患者の体内における検出物質の存在に相関す る量の、試薬を用いない直接的測定に適している。 本発明の最も一般的な形態において、該検出物質はその薬剤自体、すなわち治 療活性を有する薬剤によって形成され得る。しかしながらこれは、非侵入的方法 で検出可能な活性薬剤に限られる。ほとんどすべての化学療法薬は、かかる検出 に用い得る特徴的なIRバンドを有する。非侵入性検出を助ける薬剤の例としてば 、テトラサイクリン、ニトロフロンおよびナリジキシン酸などの抗生物質、結核 薬、リファンピシンおよびイソニコチン酸ヒドラジド、マラリア薬クロロキンサ ルフェート、ならびにマラマーなどの抗凝血薬およびニトログリセリン、ジゴキ シンなどの心臓/循環薬が挙げられる。 その他の場合では、典型的なIRバンドは体内に自然に存在する物質のバンドと 重なっている。このような場合、あるいは有効薬の濃度が小さすぎる場合、本発 明の好ましい態様によれば、投与剤形に含まれる非侵入的に検出可能な物質は該 薬剤(活性薬剤)とは異なる無毒の標識物質である。該標識物質は、患者の体内 におけるその存在を容易に検出できるにもかかわらず、それが医薬の活性薬剤の 医薬的効果を侵害せず、しかも患者の体内でさらなる負の副作用を持たない(好 ましくは、体内で完全に不活性である)ように選択される。この態様により、そ の検出の容易性に関して標識物質を最適化することができる。本発明の好ましい 態様によれば、必要であれば、身体に対する傷害性の有毒作用を、巨大分子保護 分子構造、特にデンドリマーおよびフルバレンからなる群より選択される保護分 子内への封入または結合により回避することができる。 以下、該薬物とは別の専用の標識物質の使用に関してさらに本発明を説明する 。しかしながら、これは概して、活性薬剤自体が適切な検出物質としての特性を 有する場合への普遍性を制限するものではない。 種々の物理的に測定可能な量を測定量として広く用いることができる。例とし ては電磁線(特にIRまたは可視領域の光)の強度、周波数または位相、音響シグ ナルの強度、周波数または位相、磁場の強度または極性がある。この測定量は、 薬剤の摂取に伴う標識物質の濃度変化が検出装置を用いるその測定を通じて検出 できるような測定可能な様式で、患者の体内における標識物質の存在により影響 を受けるものでなければならない。かかる測定量は本質的に、慣例の英語用法( 「定量可能パラメーター」)に従って「パラメーター」という。 本発明によれば、通常、患者の体内における標識物質濃度の定量的測定は必要 とされない。該検出装置はむしろ、時間に依存するパラメーターの変化を測定す る手段を含んでなることが好ましい。測定シグナルからの差異化または差異率の 測定に必要な電子的手段は当該技術分野で公知である。パラメーター測定シグナ ルの増加または減少を薬剤摂取の指標として利用すること、すなわち、所定の変 化の最小限界速度においてパラメーター測定シグナルが増加または減少した場合 、標識物質の「検出」に対応する出力シグナルが生じることが好ましい。 本発明は種々の医薬投与剤形に適する。特に経口投与(錠剤、カプセル剤など )において重要であるが、薬剤の規則的な投与の監視が必要とされる限り、坐薬 や注射などの他の投与剤形にも使用可能である。この標識物質は、対応する投与 剤形に適した医薬形態でなければならないことは明白である。 以上のように、本発明は、種々の操作原理、すなわち全く異なる標識物質と検 出装置との間の相互作用に基づいて具体化することができる。好ましい実施例を 以下に記載する。 第一の態様では、標識物質は、好ましくはIR領域の光スペクトルにおいて染色 特性を有する。適当な検出装置は、皮膚を通して患者の体内へ適当な波長の光を 照射し、次いで、そこに含まれる化合物と(また、それにより標識物質とも)相 互作用した後に身体から出てくる光を測定する。このシステムの構成要素は、で きるだけ強い反射光強度が、標識物質が最大吸収を有するスペクトル領域にある ように、相互に調整し、適合させると有利である。これらの波長は、好ましくは 、それらが患者の体内(特に皮膚内)に高濃度で含まれる光吸収物質の最大吸収 の外側、特に水およびヘモグロビンの吸収バンドの外側にあるように選択される 。 一度、標識物質とそれに関する検出波長が選択されると、体内の、特にヒト皮 膚内の構成要素の検出のための常法が使用できる。かかる方法は当該技術分野に おいて、特にヒト(ヘモグロビン、デソキシヘモグロビンならびにシトクロムa およびa3)における酸素化過程に重要な被検物質の非侵入性分析に関して公知で ある。この目的に対し、本明細書では、これまでの刊行物に対しての多数の引用 を伴う米国特許第5,028,787号(Rosenthalら)、および米国特許第5,285,783号(Se cker)を引用する。 かかるIR検出法では、通常、複数の波長で光を照射し、スペクトルに依存する 光の測定パラメーターを用いて標的物質を検出する。本発明はまた、標識物質を 分光学的に検出するために、複数の波長を用いて操作することが好ましい。 特に適した操作原理は、標識物質としての蛍光染料の使用に基づき、ここで検 出装置は蛍光のin vivo検出に適している。この目的に対し、その波長が蛍光染 料の吸収波長に対応している光を患者の体内へと照射する。そのための光源とし てはレーザーが特によく適している。生じた蛍光放射を波長選択的に検出する。 可視光の最長波長域および近赤外線で放射する蛍光染料を使用することが好まし い。約600nmおよび約800nmの間の波長が特に好ましい。放射された蛍光強度が低 くとも、使用可能シグナルと妨害シグナルとの重なりが比較的少なく、結果とし て他の方法と比較してノイズに対するシグナルの比率が良好なので、この相互作 用のメカニズムは本発明の目的のために特に十分に適切であることが判明した。 ヒト体内の被検物質の非侵入性検出のため、本発明と同様に適切ないくつかの 公知の方法では、異なる照射位置から皮膚を通して体内に光を照射し、さらに/ あるいは光が異なる光路に沿って対応する照射位置から検出位置まで通過するよ うに、皮膚から出てくる光を異なる検出位置で検出する。異なる光路について測 定した測定シグナルをさらに処理して所望の分析情報を提供する。この方法は、 皮膚組織内の特定の層に対して規定された様式で分析を行おうとするものである 。この種の方法は例えば、米国特許第4,867,557号(Takatani)および米国特許第5 ,057,695号(Hirao)に記載されている。 非侵入性分析のさらなる公知の方法では、いわゆる「周波数ドメイン分光学的 測定」を行う。ここで照射光は高周波で変調し、照射光に対する検出光の周波数 シフトまたは変調の程度を、被検物質の存在に相関するパラメーターとして利用 する。この点に関し、Chanceの米国特許第5,187,672号、そこに挙げられた刊行 物、ならびにWO 95/32416が参照される。この方法はまた、本発明の枠組み内で 有利に使用できる。 適切な標識物質は例えば、診断へ適用するための標識分子として開発された分 子であってよい。例としては: −蛍光標識物質、特にWO 96/03410に記載されたものなどの、フルオレセイン および蛍光金属錯体化合物 −WO 96/03650に記載のDNA診断法などの免疫学的検出法用に開発された検 出物質 −例えばEP-B-0567622の吸収または蛍光染料 がある。 ある場合には、その磁気的な相互作用が皮膚を通して検出できる強磁性微粒子 を標識物質として用いることもできる。 さらに可視スペクトルの外側、好ましくは電波およびマイクロ波内の波長を有 する電磁線をプローブとして用いて患者の体内の標識物質の存在を検出すること もできる。この場合、特にダイオードの特性を有する物質を標識物質として用い ることができる。詳細はWO 92/15013に記載されている。ここでは標識物質はそ れによりダイオード挙動を引き起こすp-n-遷移を有し、すなわち電場中で該物質 はある電場方向に伝導され、他の電場方向には高い抵抗性を有する。このような 半導体ダイオードは、それらが原則として薬剤中の標識物質として適切であるよ うに、ミクロに小型化した形態で製造され得る。検出は高周波シグナル、好まし くは引用のWO 92/15013公報に記載されているようなMHzレンジ内のシグナルとの 相互作用により達成される。 以下に本発明の態様が示される図面を参照して、本発明をさらに詳しく説明す る。 図1は本システムの構成要素の概略図を示し、 図2は検出装置および不変照会ユニットのブロック線図を示し、 図3は本発明の一態様についてのスペクトルのグラフ表示を示す。 制御システムは、本質的に、星印で示された標識物質を含有する薬剤投与剤形 1(ここでは錠剤)と、示された好ましい態様では患者3がつけている腕時計とし て具体化されている検出装置2とから構成される。通常身体につける装置の形態 で構成されたかかる検出装置は、目立たない方法でその監視機能を遂行し、患者 に不快感を引き起こさない。一般に、監視装置は携帯に容易なよう十分小さく、 かつ軽くあるべきである。 検出装置2の重要な構成要素は、ブロック線図の形で図2に示されている。それ は、例えば光ダイオードおよび半導体光検出器の形態で照射および検出手段4お よび5を含んでいる。検出手段のシグナルは測定および分析回路6により(例えば 、 引用された刊行物に記載された方法の1つを用いて)、患者3の体内における標 識物質の存在に関するデータへと処理される。これらのデータは装置2のメモリ ー8に保存される。測定時間を照会し、またメモリー8に同様に保存するために、 時間計測装置9が提供される。 絶対濃度を測定する必要はないので、該検出装置は、前記のヒト体内における 物質の非侵入性分析のための公知の方法に比べ、比較的単純な設計であってよい 。それは薬剤の摂取に伴う標識物質の濃度の増加を検出するのに十分である。こ れは例えば、限界値を用いて、または(好ましくは)パラメーターの経時変化( すなわち、測定シグナルの第一の派生物と考えられる)の測定を通じて達成でき る。精巧な較正手段も必要としない。 メモリー8に保存されたデータはさらに、マイクロプロセッサーで制御された 測定および分析ユニットにより常法にて処理できる。特に、同ユニットは、患者 が、次いで検出され得る薬剤を摂取したかどうかを確認するために、ある所定の 時間(例えば1日1回)に測定値の監視を開始するする手段となるプログラムを 含み得る。このプログラムはまた、監視に関して負の結果が出た場合には、薬剤 の摂取に関して患者に勧告するための音響シグナル送信機11を作動させることに より警告シグナルを発することもできる。これは種々の方法で改良可能である。 例えば、事前の監視なしに、音調を用いて、患者に薬剤の摂取を思い出させ、さ らに検出装置2の助けによる標識物質の検出を通じて、ある所定の時間内でその 摂取を確認することができる。 患者自身による、および/または主治医による規則的摂取の長期にわたる監視 を簡略化するため、標識物質の検出および測定時間に関するデータを検出装置2 から外部データ受信ユニット12へ転送することができる。この外部データ受信ユ ニットは、患者自身または医師のもとに置くことができる。患者および医師が同 じまたは異なるデータ受信ユニットを所持することができることは明らかである 。一般に、検出装置2とデータ受信ユニット12は、患者が標識物質の検出に関す るデータを消去したり、操作したりできないような様式で構成されるべきである 。 示された好ましい態様では、検出装置2から外部データ受信ユニット12へのデ ータの転送は無線により行われ、ここでは検出装置2は送信機13を有し、データ 受信ユニット12は受信機14を有している。送信は、例えば赤外線を用いて、また はFM電波シグナルによって達成される。あるいは、外部データ受信ユニット12が ケーブルを用いて時々にそこへ連結される、検出装置2へのケーブル送信用デー タポートが提供されてもよい。 適した標識物質のin vivo検出能の調査を動物実験にて行った。ブリリアント ブルーFCFと呼ばれる、FDAにより認可された食用染料をマウスに給餌した。 この蛍光染料の蛍光を、マウスの耳にてin vivoで測定した。励起は1.5mWの電源 および632.8nmの波長を有するヘリウムネオンレーザーを用いて行った。蛍光放 射を、マウスの耳で光ファイバーを用いて検出し、蛍光分光計の発光モノクロメ ーターに焦点を合わせた。得られたスペクトルを最大値に対して正規化したもの を図3に示すが、ここで、強度I(各場合における最大値に対するもの)は波長( nm)に対してプロットされている。測定曲線16は耳における(三角の測定点)in vivo測定の結果を示す。測定曲線17は、同分光計を用いた染料スペクトルのin v itro測定に関して、同様に最大値に対して正規化した結果を比較するものである 。in vivoでの測定はin vitroでの測定と非常によく一致している。これにより 、比較的簡単な手段と適切な波長(特に最大発光スペクトル付近)を用いて、生 理学的に安全な染料の濃度変化をin vivoで確実に検出できると結論づけること ができる。DETAILED DESCRIPTION OF THE INVENTION                      Monitoring system for regular intake of drugs   The present invention relates to a system for monitoring the regular ingestion of drugs by a patient, and to such monitoring Drug dosage form for the system.   Regular intake of a drug is often critical for its effectiveness. example For example, with antibiotics, incomplete termination can lead to disease recurrence and the development of resistance . However, drugs may not be taken regularly according to the prescription or may be taken at incomplete stages Is often interrupted. Therefore, regular drug intake is extremely important. For certain treatments (eg, TBC, HIV and other serious infections) Inpatient treatment of the patient is required to ensure individual monitoring of regular dosing. Inpatient treatment of patients simply for the purpose of monitoring drug intake Can be detrimental to the recovery process and can be very expensive.   Therefore, there is an urgent need for reliable monitoring of regular intake of drugs at a reasonable cost It is. At present, there is no solution to this problem. Some including drug therapy Analysis of blood drug levels (so-called “drug tests”) To adjust the optimal effective concentration of the drug. However, such methods are not Only available for drugs, blood is collected for each test and at the same time relatively difficult New analytical methods need to be performed. In drug testing, patient self-monitoring of drug intake is No, doctors cannot monitor regular drug intake without patient cooperation. I can't.   To solve this problem, the present invention provides a system component that is adapted to each other. The dosage form of the drug and the substances contained in that dosage form in the patient's body (hereinafter Monitoring system that includes a detection device for non-invasive detection of It is a suggestion. The detection device correlates to the presence of the detection substance in the patient's body. Suitable for direct measurement without reagents in small volumes.   In the most general form of the invention, the detection substance is the drug itself, It can be formed by therapeutically active agents. However, this is a non-invasive method Limited to active agents detectable by Almost all chemotherapeutic drugs detect such It has a characteristic IR band that can be used for Examples of drugs that help non-invasive detection Antibiotics, including tuberculosis, tetracycline, nitrofuron and nalidixic acid, tuberculosis Drugs, rifampicin and isonicotinic hydrazide, malaria drug chloroquinsa Rufate and anticoagulants such as malamers and nitroglycerin, digoki Cardio / circulatory drugs such as Shin.   In other cases, a typical IR band will be a band of a substance naturally present in the body. overlapping. In such cases, or when the active drug concentration is too low, According to certain preferred embodiments, the non-invasively detectable substance contained in the dosage form is It is a non-toxic labeling substance different from drugs (active drugs). The labeling substance is in the patient's body. Despite being able to easily detect its presence in It does not violate the medicinal effect and has no further negative side effects in the patient's body (good Preferably, it is completely inert in the body). With this aspect, The labeling substance can be optimized with respect to the ease of detection. Preferred of the present invention According to embodiments, if necessary, the toxic effects of damaging to the body can be protected by macromolecules Molecular structure, in particular a protected moiety selected from the group consisting of dendrimers and fulvalenes It can be avoided by encapsulation or bonding in the offspring.   Hereinafter, the present invention will be further described with respect to the use of a dedicated labeling substance separate from the drug. . However, this generally means that the active agent itself has properties as a suitable detection substance. It does not limit the universality of having.   Various physically measurable quantities can be widely used as measured quantities. As an example The intensity, frequency or phase of electromagnetic radiation (especially IR or visible light), There are null strength, frequency or phase, magnetic field strength or polarity. This measure is A change in the concentration of the labeling substance accompanying the ingestion of the drug is detected through its measurement using a detection device Affected by the presence of the label in the patient's body in a measurable manner as possible Must receive Such measurements are essentially based on customary English usage ( "Parameter" according to "quantitable parameter").   According to the present invention, it is usually necessary to quantitatively measure the concentration of a labeled substance in the body of a patient. And not. Instead, the detector measures changes in time-dependent parameters. It is preferable to include means for performing the above. Differentiation or percentage difference from the measured signal The electronic means necessary for the measurement are known in the art. Parameter measurement signal The increase or decrease of the drug as an indicator of drug intake, i.e., The parameter measurement signal increases or decreases at the minimum critical speed of Preferably, an output signal corresponding to "detection" of the labeling substance is generated.   The present invention is suitable for various pharmaceutical dosage forms. Especially oral administration (tablets, capsules, etc.) ), But suppositories should be used as long as regular drug monitoring is required. It can be used in other dosage forms such as injections and injections. This labeling substance is Obviously, the pharmaceutical form must be suitable for the dosage form.   As described above, the present invention provides various operation principles, that is, detection with completely different labeling substances. It can be embodied on the basis of the interaction with the exit device. Preferred embodiment It is described below.   In the first embodiment, the labeling substance is preferably stained in the light spectrum in the IR region. Has characteristics. Appropriate detection devices will direct light of the appropriate wavelength through the skin and into the patient's body. Irradiation, and then the compound contained therein (and thereby also the labeling substance) Measure the light coming out of the body after interacting. The components of this system are: The reflected light intensity is as strong as possible in the spectral region where the labeling substance has the maximum absorption As such, it is advantageous to coordinate and adapt to each other. These wavelengths are preferably , Maximum absorption of light-absorbing substances contained in high concentrations in the patient's body (especially in the skin) Outside, especially outside the water and hemoglobin absorption bands .   Once the label and its detection wavelength have been selected, the body, especially human skin, Conventional methods for the detection of skin components can be used. Such methods are well known in the art. In particular, human (hemoglobin, desoxyhemoglobin and cytochrome a And for non-invasive analysis of test substances important in the oxygenation process in a3) is there. To this end, the present specification has provided a number of references to previous publications. U.S. Pat.No. 5,028,787 (Rosenthal et al.) And U.S. Pat. cker).   Such IR detection methods typically irradiate light at multiple wavelengths and depend on the spectrum The target substance is detected using the light measurement parameters. The present invention also provides a labeling substance. It is preferred to operate with multiple wavelengths for spectroscopic detection.   A particularly suitable operating principle is based on the use of fluorescent dyes as labeling substances and is The emission device is suitable for in vivo detection of fluorescence. For this purpose, the wavelength is The light corresponding to the absorption wavelength of the sample is radiated into the patient's body. As a light source for that Lasers are particularly well suited. The resulting fluorescent radiation is detected wavelength-selectively. It is preferred to use fluorescent dyes that emit in the longest wavelength range of visible light and near infrared No. Particularly preferred are wavelengths between about 600 nm and about 800 nm. Low emitted fluorescence intensity At least, there is relatively little overlap between the usable and interfering signals, resulting in The ratio of signal to noise is better than other methods, The mechanism for use has been found to be particularly well suited for the purposes of the present invention.   For non-invasive detection of a test substance in the human body, some suitable In a known method, light is radiated into the body through the skin from different irradiation positions, and Alternatively, the light may pass along the different optical paths from the corresponding irradiation position to the detection position. Thus, the light coming out of the skin is detected at different detection positions. Measurement for different optical paths The determined measurement signal is further processed to provide the desired analytical information. This method Attempts to analyze a specific layer in skin tissue in a prescribed manner . Such methods are described, for example, in U.S. Pat.No. 4,867,557 (Takatani) and U.S. Pat. No. 057,695 (Hirao).   A further known method of non-invasive analysis is the so-called "frequency domain spectroscopy". Measurement. Here, the irradiation light is modulated at a high frequency, and the frequency of the detection light with respect to the irradiation light is Use the degree of shift or modulation as a parameter that correlates to the presence of the analyte I do. In this regard, Chance U.S. Patent No. 5,187,672, the publications cited therein And WO 95/32416. This method is also within the framework of the present invention. It can be used to advantage.   Suitable labeling substances include, for example, those developed as labeling molecules for diagnostic applications. May be a child. Examples are:   Fluorescein, such as fluorescent labeling substances, especially those described in WO 96/03410 And fluorescent metal complex compounds   -A test developed for immunological detection methods such as the DNA diagnostic method described in WO 96/03650 Substance   -For example, absorption or fluorescent dyes of EP-B-0567622 There is.   In some cases, ferromagnetic particles whose magnetic interaction can be detected through the skin Can also be used as a labeling substance.   In addition, wavelengths outside the visible spectrum, preferably within radio waves and microwaves The presence of labeled substances in the patient's body using the changing electromagnetic radiation as a probe You can also. In this case, a substance having the characteristics of a diode is used as the labeling substance. Can be Details are described in WO 92/15013. Here, the labeling substance is Have a p-n-transition which causes diode behavior, i.e. Are conducted in one electric field direction and have high resistance in other electric field directions. like this Semiconductor diodes are suitable in that they are, in principle, suitable as markers in drugs. Thus, it can be manufactured in a micro-miniaturized form. Detection is high frequency signal, preferred Or with signals in the MHz range as described in WO 92/15013 cited. Achieved by interaction.   Hereinafter, the present invention will be described in more detail with reference to the drawings, in which embodiments of the present invention are shown. You.   Figure 1 shows a schematic diagram of the components of the system,   FIG. 2 shows a block diagram of the detection device and the invariant query unit,   FIG. 3 shows a graphical representation of a spectrum for one embodiment of the present invention.   The control system consists essentially of a drug dosage form containing a label, indicated by an asterisk. 1 (here a tablet) and, in the preferred embodiment shown, a wristwatch worn by patient 3. And a detection device 2 embodied as such. Types of devices usually worn on the body Such a detection device, consisting of Does not cause discomfort. In general, monitoring devices are small enough to be easy to carry, And should be light.   Important components of the detection device 2 are shown in FIG. 2 in the form of a block diagram. It The irradiation and detection means 4 and 4, for example, in the form of photodiodes and semiconductor photodetectors. And five. The signal of the detection means is determined by the measurement and analysis circuit 6 (eg , Using one of the methods described in the cited publications), Processed into data on the presence of pollutants. These data are stored in the memory of device 2. -8. To query the measurement time and store it in memory 8 as well, A time measuring device 9 is provided.   Since it is not necessary to measure the absolute concentration, the detection device is used in the human body. Relatively simple design compared to known methods for non-invasive analysis of substances . It is sufficient to detect an increase in the concentration of the label with the ingestion of the drug. This This can be done, for example, using threshold values or (preferably) parameter aging ( That is, it is considered the first derivative of the measurement signal). You. No elaborate calibration measures are required.   The data stored in memory 8 was further controlled by a microprocessor. It can be processed in the usual way by a measurement and analysis unit. In particular, the unit is Has determined that they have ingested a drug that can then be detected. A program that is a means to start monitoring measured values at a time (for example, once a day) May be included. The program will also provide a drug Actuating the acoustic signal transmitter 11 to advise the patient about ingestion of More warning signals can be issued. This can be improved in various ways. For example, tones can be used to remind patients to take drugs without prior monitoring. Further, through the detection of the labeling substance with the aid of the detection device 2, the You can check your intake.   Long-term monitoring of regular intake by the patient and / or by the attending physician Data on the detection time and measurement time of the labeling substance To the external data receiving unit 12. This external data receiving user The knit can be placed on the patient himself or the doctor. Patient and doctor Obviously you can have the same or different data receiving units . In general, the detection device 2 and the data receiving unit 12 allow the patient to detect the labeling substance. Should be structured in such a way that data cannot be erased or manipulated .   In the preferred embodiment shown, data from the detection device 2 to the external data receiving unit 12 Data transfer is performed wirelessly, where the detector 2 has a transmitter 13 and The receiving unit 12 has a receiver 14. Transmission can be performed, for example, using infrared, Is achieved by FM radio signals. Alternatively, the external data receiving unit 12 The data for cable transmission to the detector 2 that is sometimes connected to it using a cable A tapport may be provided.   The in vivo detection ability of a suitable labeling substance was investigated in animal experiments. brilliant Mice were fed a food dye approved by the FDA called Blue FCF. The fluorescence of this fluorescent dye was measured in vivo in the mouse ear. Excitation is 1.5mW power supply And a helium neon laser having a wavelength of 632.8 nm. Fluorescent emission Radiation is detected in the ears of the mouse using an optical fiber, and the emission monochrome Focused on the data. The obtained spectrum normalized to the maximum value Is shown in FIG. 3, where the intensity I (for the maximum in each case) is the wavelength ( nm). Measurement curve 16 is (triangle measurement point) in ear 3 shows the results of in vivo measurements. Measurement curve 17 is the in v of the dye spectrum using the same spectrometer. Compares the results of the itro measurement, also normalized to the maximum value. . In vivo measurements are in very good agreement with in vitro measurements. This Using relatively simple means and appropriate wavelengths (especially near the maximum emission spectrum) To conclude that physically safe changes in dye concentration can be reliably detected in vivo Can be.

Claims (1)

【特許請求の範囲】 1.患者による薬剤の規則的摂取を監視するシステムであって、 薬物療法のための薬剤投与剤形(1)と、患者(3)の体内における該投与剤形に含 まれる物質の非侵入性検出のための検出装置(2)とを含んでなる相互に適合し たシステム構成要素を含み、該検出装置(2)が、患者の体内における物質の存 在に相関する物理的に測定可能なパラメーターの、試薬を用いない直接的測定 に適していることを特徴とする該システム。 2.前記投与剤形に含まれる非侵入検出が可能な前記物質が、前記薬剤とは異なる 無毒な標識物質であることを特徴とする請求項1記載の監視システム。 3.前記薬剤または前記標識物質が測定可能なように身体へ照射される電磁線に影 響を与え、かつ、前記検出装置が、患者の体内へ電磁線を照射するための照射 手段(4)と、該電磁線と該薬剤または該標識物質との間の相互作用の後に、体 内におけるその存在と相関するパラメーターとしての放射の量を測定するため の検出手段(5)とを含むことを特徴とする請求項1または2のいずれか1項に 記載の監視システム。 4.前記電磁線が、特に可視領域または赤外領域の光スペクトルの、光であること を特徴とする請求項3記載の監視システム。 5.前記放射手段(4)が複数の波長の電磁線照射のために構成され、かつ、前記パ ラメーターのスペクトル依存性を前記標識物質の検出のために使用することを 特徴とする請求項4記載の監視システム。 6.前記検出装置が複数の異なる照射位置で電磁線を照射するための照射手段(4) および/または複数の異なる位置で電磁線を検出するための検出手段を含み、 かつ、それぞれの照射位置とそれぞれの検出位置の間の測定距離に対する検出 パラメーターの依存性を標識物質の検出のために使用することを特徴とする請 求項3〜5のいずれか1項に記載の監視システム。 7.前記薬剤または前記標識物質が蛍光染料を含み、かつ、前記検出装置が体内に おける標識物質の存在に相関するパラメーターとしての蛍光のin vivo検出に 適していることを特徴とする請求項3または4のいずれか1項に記載の監視シ ステム。 8.前記検出装置が前記パラメーターの経時変化を測定するための手段を含み、か つ、該パラメーターの増加または減少を薬剤の摂取を検出するために使用する ことを特徴とする請求項1〜7のいずれか1項に記載の監視システム。 9.前記検出装置(2)が身体に携帯できるセンサーユニットを含むことを特徴とす る請求項1〜8のいずれか1項に記載の監視システム。 10.前記検出装置(2)が慣習的に身体につけられる装置の形態で、特に腕時計とし て、構成されていることを特徴とする請求項1〜9のいずれか1項に記載の監 視システム。 11.前記検出装置が、時間計測装置(9)、および前記標識物質の検出に関するデー タの保存のためのメモリー(8)を含むことを特徴とする請求項1〜10のいず れか1項に記載の監視システム。 12.所定の時間内に患者の体内で標識物質が検出されない場合に、前記検出装置 (2)が警告シグナルを発することを特徴とする請求項11記載の監視システム 。 13.前記検出装置が、外部データ受信ユニットへのデータの転送のためのボート を含むことを特徴とする請求項1〜12のいずれか1項に記載の監視システム 。 14.前記検出装置が、外部データ受信ユニットへのデータの無線転送のための送 信機(13)を含むことを特徴とする請求項11記載の監視システム。 15.活性薬剤の他に、患者の体内におけるその存在が検出装置を用いる非侵入方 式で測定できる無毒な標識物質を含むことを特徴とする、請求項2〜14のい ずれか1項に記載の監視システム用の薬剤投与剤形。 16.前記標識物質が蛍光染料を含むことを特徴とする請求項15記載の薬剤投与 剤形。 17.前記標識物質が、巨大分子保護分子構造内への封入または組み込みによって 無毒にされていることを特徴とする請求項15記載の薬剤投与剤形。 18.前記巨大分子保護分子構造がデンドリマーおよびフルバレンからなる群に属 することを特徴とする請求項17記載の薬剤投与剤形。[Claims] 1. a system for monitoring the regular intake of drugs by a patient,   The dosage form for drug therapy (1) and the dosage form in the body of the patient (3) are included.   And a detection device (2) for non-invasive detection of contained substances   Detection system (2), wherein the detection device (2) contains a substance present in the patient's body.   Direct measurement without reagents of physically measurable parameters correlated with location   The system is suitable for: 2. The substance contained in the dosage form and capable of non-invasion detection is different from the drug   The monitoring system according to claim 1, wherein the monitoring system is a non-toxic labeling substance. 3. The drug or the labeling substance is affected by electromagnetic radiation that is radiated to the body so that it can be measured.   For irradiating the subject with electromagnetic radiation to the body of the patient.   After the means (4) and the interaction between the electromagnetic radiation and the drug or the labeling substance,   To measure the amount of radiation as a parameter that correlates to its presence in the   And a detecting means (5).   The described monitoring system. 4. The electromagnetic radiation is light, particularly in the visible or infrared region of the light spectrum.   The monitoring system according to claim 3, wherein: 5. The radiating means (4) is configured to irradiate electromagnetic rays of a plurality of wavelengths, and   Using the spectral dependence of the parameters for the detection of the labeled substance.   The monitoring system according to claim 4, characterized in that: 6.Irradiation means (4) for the detection device to irradiate electromagnetic rays at a plurality of different irradiation positions   And / or detecting means for detecting electromagnetic radiation at a plurality of different locations,   In addition, detection for the measurement distance between each irradiation position and each detection position   A contractor characterized in that the dependence of the parameters is used for the detection of the labeling substance.   The monitoring system according to any one of claims 3 to 5. 7. The drug or the labeling substance contains a fluorescent dye, and the detection device is inside the body.   In vivo detection of fluorescence as a parameter correlated with the presence of a labeling substance in   Monitoring system according to claim 3 or 4, characterized in that it is suitable.   Stem. 8. The detection device includes means for measuring a change over time of the parameter,   Using the increase or decrease of the parameter to detect drug intake   The monitoring system according to claim 1, wherein: 9. The detection device (2) includes a sensor unit that can be carried on the body.   The monitoring system according to claim 1. 10.The detection device (2) is in the form of a device conventionally worn on the body, especially as a wristwatch.   The supervisor according to any one of claims 1 to 9, wherein   Vision system. 11.The detection device is a time measurement device (9) and data on the detection of the labeling substance.   11. A memory according to claim 1, further comprising a memory for storing the data.   The monitoring system according to claim 1. 12.If no labeled substance is detected in the patient within a predetermined time, the detection device   The monitoring system according to claim 11, wherein (2) emits a warning signal.   . 13. The detecting device comprises a port for transferring data to an external data receiving unit.   The monitoring system according to any one of claims 1 to 12, comprising:   . 14. The detecting device transmits the data to an external data receiving unit for wireless transfer.   The monitoring system according to claim 11, further comprising a transceiver (13). 15. In addition to the active agent, its presence in the patient's body is a non-invasive method using a detection device   A non-toxic labeling substance which can be measured by an equation, characterized in that it comprises:   A dosage form for a monitoring system according to any one of the preceding claims. 16. The drug administration according to claim 15, wherein the labeling substance includes a fluorescent dye.   Dosage form. 17. The labeling substance is encapsulated or incorporated into the macromolecular protective molecular structure.   16. The dosage form of claim 15, wherein the dosage form is non-toxic. 18. The macromolecular protective molecular structure belongs to the group consisting of dendrimers and fulvalenes.   18. The dosage form of claim 17, wherein the dosage form is administered.
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